Enkele nieuwe en - NVvA Worker population/tasks Observed health effect Emerging risk ... fibres...

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Transcript of Enkele nieuwe en - NVvA Worker population/tasks Observed health effect Emerging risk ... fibres...

  • Enkele nieuwe en opkomende risicos nader beschouwd

    Nicole Palmen, PhD

    Arbeidshyginist/toxicoloog

    1 Nieuwe en opkomende risico's | 13 april 2016

  • Nieuwe en opkomende risico's | 13 april 20162

  • Overzicht bronnen voor opsporen nieuwe risicos

    Case reports (clinical watch system: SIGNAAL)

    Mn voor ernstige ziekten met lage incidentie

    Periodieke screening van de literatuur en websites (tekst mining)

    Data mining in databases (indien beschikbaar)

    Zoeken naar relatie: werk blootstelling gezondheidseffect

    Health surveillance (preventief medisch onderzoek)

    Periodiek screenen van wn met blootstelling aan bepaalde stof

    Secundaire analyse van andere bronnen (gezondheidsdienst, huisartsen, kankerregisters etc.)

    Nieuwe en opkomende risico's | 13 april 20163

  • Detecting emerging risks for workers and follow-up actions, RIVM Rapport 601353004Palmen NGM, Salverda-Nijhof JGW, van Kesteren PCE, ter Burg W (2013)

    Nieuwe en opkomende risico's | 13 april 20164

    Substance Worker population/tasks Observed health effect Emerging risk (concern)

    Formaldehyde Hair dressers - use of hair straightening products

    Irritation skin, eyes and respiratory tract, allergies

    Increased/illegal use of the products

    Indium tin oxide Manufacture of flat-panel displays (LCD, plasma screen)

    Pulmonary fibrosis New technology

    Crystalline silica (sand) Sandblasting of textiles Silicosis New use, intensifiedexposure

    Synthetic polymeric fibres

    Textile workers from a nylon flocking plant

    Interstitial lung disease (Flock worker's lung)

    New risk

    Tricresyl phosphate Cockpit and cabin crew 'Aerotoxic syndrome' (neurological symptoms)

    New exposure scenario

    Diacetyl-containing flavorings

    flavoring production and application

    Bronchiolitis obliterans New risk

    5-Aminosalicylic acid Drug manufacturing Occupational asthma New risk

    Hexamethylene diisocyanate

    Paint quality controller Acute life-threatening etrinsic allergic alveolitis

    New riskDermal exposure is New route of exposure

    Methylene diphenyl diisocyanate (MDI)

    Orthopedic plaster casts workers Occupational asthma exposure levels lower than OEL

  • Vervolg

    Nieuwe en opkomende risico's | 13 april 20165

    Substance Worker population/tasks Observed health effect Emerging risk (concern)

    Trichloroethylene (TCE) Industrial machinery repairer, industrial worker

    Parkinson Disease New risk

    Pesticides -methylbromide andphosphine residual gases (fumigation of containers)

    Dock workers - opening of containers

    Respiratory disorders, neurotoxic symptoms, mild acute health effects

    New exposure scenario

    Cleaning spray (including chlorine, bleach, disinfectants) -bleach, ammonia, decalcifiers, acids, solvents and stain removers

    Professional cleaners Occupational asthma Increased use of sprays

    Etcetera.

  • Nieuwe en opkomende risico's | 13 april 20166

  • Impact analysis: semi kwantitatieve methodiek risicoscoring

    Nieuwe en opkomende risico's | 13 april 20167

    Impact: ernst gezondheidseffect

    Likelyhood: hoeveelheid bewijs

  • Prioritering

    Prioriteit = risicoscore x productie/gebruik in NL

    Nieuwe en opkomende risico's | 13 april 20168

    Risk score human health

    Manufacturing/use in the Netherlands

    Risk priority

    20 25: Red Yes 1: red20 25: Red Limited

    In the past fort his use, but possibly elsewhereStrongly reduced

    2: orange

    20 25: Red No 3: green12 16: Orange Yes 2: orange12 16: Orange Not likely but possible 2: orange12 16: Orange No 3: green5 11: Yellow Yes 3: green5 11: Yellow No 3: green1 4: Green Yes 3: green1 4: Green No 3: green

    Risico prioriteit Rood: Direct actie noodzakelijk Oranje: Actie noodzakelijk Groen: Minimum actie

  • Prioritering; 3 voorbeelden

    Nieuwe en opkomende risico's | 13 april 20169

    Substance

    name

    CAS-

    number

    Classification Observed health

    effect

    Occupation Risk

    score

    Use in NL Risk

    Priority

    Diacetyl-

    containing

    flavourings

    431-03-8 Flam. Liq. 2

    Acute tox 3: inhaled

    Acute tox 4. swallowed, inhaled

    Skin Irrit 2

    Skin Sens 1

    Eye Dam. 1

    Eye irritation 2

    STOT RE 2 (damage organs)

    STOT RE 3 (resp irr)

    Aquatic chronic 3

    Bronchiolitis

    obliterans

    Workers in

    flavouring

    production facility

    and workers that

    apply flavours

    (microwave popcorn

    production facility,

    cookie factory,

    coffee processing

    facility)

    25 Yes 1

    Indium tin

    oxide

    50926-11-9 Skin irrit: 2

    Eye irrit: 2

    STOT SE 3: may cause

    respiratory irritation

    Pulmonary

    fibrosis,

    pulmonary

    alveolary

    proteinosis

    Manufacture of flat-

    panel displays

    (LCD, plasma

    screen). Use at

    universities and

    laboratories,

    possibly also waste

    treatment

    (recycling).

    25 limited 2

    Tricresyl

    phosphate

    1330-78-5 Skin Sens 1

    Skin Sens. 1B

    Eye Irrit 2

    Repr 2

    STOT RE 2

    Aquatic Acute 1

    Aquatic chronic 1

    Aquatic chronic 2

    Acute Tox 4 (inhaled, oral, skin)

    'Aerotoxic

    syndrome'

    (neurological

    symptoms)

    Pilots

    Cabin crew

    15 Yes 2

  • Informatie uit EU databases

    Registratie van stof/mengsel

    Classificatie

    Community Rolling Action Plan (CoRAP) Substance Evaluation

    Substances of Very High Concern (SVHC)

    Authorisation / Restriction

    Andere lijsten:

    Biocidal Products Regulation

    Public Activities Coordination Tool (PACT) lists RMOA

    Prior Informed Consent (PIC) list

    Nieuwe en opkomende risico's | 13 april 201610

  • Nieuwe en opkomende risico's | 13 april 201611

  • Methode: opsporen en duiden in 4 fasen (in NL):

    Signaaldetectie: opsporen mogelijk relevante verbanden tussenblootstelling en gezondheidsklachten

    Text mining: literatuuronderzoek

    Data mining: onderzoeken van gegevensbestanden

    Spontane meldingen (consumenten, werknemers/(bedrijfs)arts)

    Actieve opsporing gezondheidseffecten

    Signaalversterking (Expertgroep): voorlopige beoordeling van beschikbare gegevens en argumenten (evidence)

    Relatie - blootstelling effect vaker gemeld?

    Signaalbevestiging: follow-up en nader onderzoek

    Voorlopig oordeel over het nieuwe/toenemende risico

    Van signaal naar actie: (risico)communicatie, vervolgonderzoeken evt. maatregelen

    Nieuwe en opkomende risico's | 13 april 201612

    Bew

    ijs v

    oo

    r c

    au

    salite

    it

  • Van signaal naar actie:

    Follow-up (actie):

    Afleiden grenswaarde (SCOEL)

    Stof identificeren als zorgstof + aanmelden voor autorisatie (REACH)

    Stofevaluatie (REACH); vraag om meer data (blootstelling + gevaar)

    Toepassen van andere wetgeving (farmaca, cosmetica, biociden..)

    Nieuwe en opkomende risico's | 13 april 201613

    Data mining

    Dutch Expert Group Modernet

    Case reports

    Tekst mining

    International Experts

    NERCs Follow-up

  • Van signaal naar actie:

    Nieuwe en opkomende risico's | 13 april 201614

    priori

    teit

    Substance name CAS-

    number

    CLP

    Harmonized

    classification

    CoRAP

    (SEv)

    SVHC Restriction Other

    1 Formaldehyde 50-00-0 Yes Yes No No -

    1 Vinyl chloride 75-01-4 Yes No No Yes -

    1 Diacetyl-containing

    flavourings

    431-03-8 No No No No -

    1 4,4-methylene-bismorpholine 5625-90-1 Proposed No No No Potential candidates for substitution (BPR)

    1 Beryllium 7440-41-7 Yes Yes Yes No PACT-RMOA

    1 Pesticides - methylbromide and

    phosphine residual gases

    (fumigation of containers)

    74-83-9

    (methyl

    bromide)

    Yes No No No PIC-list

    1 Hexamethylene diisocyanate 822-06-0 Yes No No Yes PACT-RMOA

    1 Methylene diphenyl diisocyanate

    (MDI)

    101-68-8 Yes Yes No Yes -

    1 Methyl-methacrylate 80-62-6 Yes Yes No No -

    1 Ethylmethacrylate 97-63-2 Yes Yes No No -

    1 Trichloroethylene (TCE) 79-01-6 Yes No Yes Yes

    1 Lead 7439-92-1 Proposed No Yes Yes PACT-RMOA

    1 Cobalt 7440-48-4 Yes No No No -

    1 Triglycidyl isocyanurate (TGIC) 2451-62-9 Yes Yes Yes No -

    1 Tremolite-free chrysotile (=

    white asbestos)

    77536-68-6 Yes No No Yes PIC-list

    1 Crystalline silica (sand) 14808-60-7 No No No No -

    2 Perchloroethylene

    (=tetrachloorethylene)

    127-18-4 Yes Yes No No Existing Substances Regulation

  • Van signaal naar actie:

    Nieuwe en opkomende risico's | 13 april 201615

    priori

    teit

    Substance name CAS-number CLP Harmonized

    classification

    CoRAP

    (SEv)

    SVHC Restriction Other

    2 Indium tin oxide 50926-11-9 No No No No -

    2 Synthetic polymeric fibres n.a. n.a. n.a. n.a. n.a. n.a.

    2 Impregnation sprays for leather

    impregnation spray containing

    fluorocarbons.

    Fluorocarbon

    Perfluoroalkyl resins in solvent

    Bromochlorodifluoromethane

    n.a.

    353-59-3

    n.a.

    n.a.

    n.a.

    No

    n.a.

    n.a.

    n.a.

    No

    n.a.

    n.a.

    n.a.

    No

    n.a.

    n.a.

    n.a.

    No

    n.a.

    n.a.

    n.a.

    Import notification (PIC-list)

    2 Aerosolised ribavirin 36791-04-5 No No No No -

    2 Talc 14807-96-6 No No